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Abaskhron M, Ezzat M, Boulis AG, Safoury YE. Supercharged end-to-side anterior interosseous nerve transfer to restore intrinsic function in high ulnar nerve injury: a prospective cohort study. BMC Musculoskelet Disord 2024; 25:566. [PMID: 39033290 DOI: 10.1186/s12891-024-07650-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND High ulnar nerve injuries is known to have unfavorable motor outcomes compared to other peripheral nerve injuries in the upper extremity. Functional muscle recovery after peripheral nerve injury depends on the time to motor end plate reinnervation and the number of motor axons that successfully reach the target muscle. The purpose of this study is to assess the functional recovery, and complications following performing supercharge end-to-side (SETS) anastomosis for proximal ulnar nerve injuries. Our study focuses on the role of SETS in the recovery process of high ulnar nerve injury. PATIENT AND METHODS This study is a prospective, single-arm, open-label, case series. The original proximal nerve pathology was dealt with according to the cause of injury, then SETS was performed distally. The follow-up period was 18 months. We compared the neurological findings before and after the procedure. A new test was used to show the effect of SETS on recovery by performing a Lidocaine proximal ulnar nerve block test. RESULTS Recovery of the motor function of the ulnar nerve was evident in 33 (86.8%) patients. The mean time to intrinsic muscle recovery was 6.85 months ± 1.3, only 11.14% of patients restored protective sensation to the palm and finger and 86.8% showed sensory level at the wrist level at the end of the follow-up period. Lidocaine block test was performed on 35 recovered patients and showed no change in intrinsic hand function in 31 patients. CONCLUSION SETS exhibit a remarkable role in the treatment of high ulnar nerve damage. SETS transfer can act as a nerve transfer that can supply intrinsic muscles by its fibers and allows for proximal nerve regeneration. We believe that this technique improves recovery of hand motor function and allows recovery of sensory fibers when combined with treating the proximal lesion. TRIAL REGISTRATION Approved by Research Ethics Committee of Faculty of Medicine- Cairo University on 01/09/2021 with code number: MD-215-2021.
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Affiliation(s)
- Mina Abaskhron
- Department of Orthopaedic and Traumatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mostafa Ezzat
- Department of Orthopaedic and Traumatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Andrew Gamal Boulis
- Department of Orthopaedic and Traumatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasser El Safoury
- Department of Orthopaedic and Traumatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Postuma RB, Weintraub D, Simuni T, Rodríguez-Violante M, Leentjens AFG, Hu MT, Espay AJ, Erro R, Dujardin K, Bohnen NI, Berg D, Mestre TA, Marras C. Anticipating Tomorrow: Tailoring Parkinson's Symptomatic Therapy Using Predictors of Outcome. Mov Disord Clin Pract 2024. [PMID: 38817000 DOI: 10.1002/mdc3.14089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Although research into Parkinson's disease (PD) subtypes and outcome predictions has continued to advance, recommendations for using outcome prediction to guide current treatment decisions remain sparse. OBJECTIVES To provide expert opinion-based recommendations for individually tailored PD symptomatic treatment based on knowledge of risk prediction and subtypes. METHODS Using a modified Delphi approach, members of the Movement Disorders Society (MDS) Task Force on PD subtypes generated a series of general recommendations around the question: "Using what you know about genetic/biological/clinical subtypes (or any individual-level predictors of outcome), what advice would you give for selecting symptomatic treatments for an individual patient now, based on what their subtype or individual characteristics predict about their future disease course?" After four iterations and revisions, those recommendations with over 75% endorsement were adopted. RESULTS A total of 19 recommendations were endorsed by a group of 13 panelists. The recommendations primarily centered around two themes: (1) incorporating future risk of cognitive impairment into current treatment plans; and (2) identifying future symptom clusters that might be forestalled with a single medication. CONCLUSIONS These recommendations provide clinicians with a framework for integrating future outcomes into patient-specific treatment choices. They are not prescriptive guidelines, but adaptable suggestions, which should be tailored to each individual. They are to be considered as a first step of a process that will continue to evolve as additional stakeholders provide new insights and as new information becomes available. As individualized risk prediction advances, the path to better tailored treatment regimens will become clearer.
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Affiliation(s)
- Ronald B Postuma
- Department of Neurology, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania; Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, Neurology Department, Oxford University and John Radcliffe Hospital, Oxford, United Kingdom
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Kathy Dujardin
- Neurology and Movement Disorders Department, University of Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Lille, France
| | - Nicolaas I Bohnen
- Departments of Radiology and Neurology, University of Michigan, University of Michigan Udall Center, Ann Arbor VAMC, Ann Arbor, Michigan, USA
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Tiago A Mestre
- Division of Neurology, Department of Medicine, University of Ottawa, The University of Ottawa Brain and Research Institute, Ottawa, Ontario, Canada
- Parkinson's Disease and Movement Disorders Clinic, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Yamamoto R, Takenoshita N, Inagawa Y, Kato H, Kaneshiro K, Kamiya T, Inagawa S, Saisho A, Tsugawa A, Mastumoto Y, Yoshimura M, Saito K, Shimizu S, Sato T. Association between longitudinal changes in striatal dopamine transporter uptake and clinical features of dementia with Lewy bodies. Psychogeriatrics 2023; 23:1036-1042. [PMID: 37726104 DOI: 10.1111/psyg.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND It is widely known that there is low striatal 123 I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3- fluoropropyl) nortropane (123 I-FP-CIT) dopamine transporter single photon emission tomography (DaT-SPECT) uptake in patients with dementia with Lewy bodies (DLB). No studies to date have analyzed the association between longitudinal changes of clinical features and DaT uptake in patients with Parkinson syndrome, particularly those with DLB. The aim of this study was to investigate the association between the longitudinal changes in DaT uptake and the severity of parkinsonism and cognitive function in DLB patients. METHODS A total of 35 outpatients with probable DLB who underwent DaT-SPECT twice (at the initial examination and the follow-up period) in the Memory Disorder Clinic at the Department of Geriatric Medicine, Tokyo Medical University, were enrolled in this study between April 2014 and September 2020. The correlation between annual changes in DaT uptake and clinical features (cognitive function decline and parkinsonism) of the patients was analyzed. RESULTS A significant correlation was detected between annual changes in parkinsonism symptom severity and DaT uptake in the left posterior putamen (r = -0.39, P = 0.03), and between Mini-Mental State Examination scores and DaT uptake in all regions except the right posterior putamen (P < 0.05) in patients with DLB. CONCLUSIONS Our results suggested that the pathway from the ventrolateral tier of the substantia nigra to the putamen might be more crucial for motor function than other pathways, not only in Parkinson's disease but also in DLB.
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Affiliation(s)
- Ryo Yamamoto
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Naoto Takenoshita
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yuta Inagawa
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Hikaru Kato
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Kyoko Kaneshiro
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Tomoki Kamiya
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Shoya Inagawa
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Aya Saisho
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Akito Tsugawa
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yukari Mastumoto
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Mana Yoshimura
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Soichiro Shimizu
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Tomohiko Sato
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
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Camicioli R, Morris ME, Pieruccini‐Faria F, Montero‐Odasso M, Son S, Buzaglo D, Hausdorff JM, Nieuwboer A. Prevention of Falls in Parkinson's Disease: Guidelines and Gaps. Mov Disord Clin Pract 2023; 10:1459-1469. [PMID: 37868930 PMCID: PMC10585979 DOI: 10.1002/mdc3.13860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 10/24/2023] Open
Abstract
Background People living with Parkinson's disease (PD) have a high risk for falls. Objective To examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults. Methods A Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention. Results A recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi-domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels. Conclusion Effective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.
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Affiliation(s)
- Richard Camicioli
- Department of Medicine (Neurology) and Neuroscience and Mental Health InstituteUniversity of AlbertaEdmontonAlbertaCanada
| | - Meg E. Morris
- La Trobe University, Academic and Research Collaborative in Health & HealthscopeMelbourneVictoriaAustralia
| | - Frederico Pieruccini‐Faria
- Gait and Brain Lab, Parkwood InstituteLawson Health Research InstituteLondonOntarioCanada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & DentistryWestern UniversityLondonOntarioCanada
| | - Manuel Montero‐Odasso
- Gait and Brain Lab, Parkwood InstituteLawson Health Research InstituteLondonOntarioCanada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & DentistryWestern UniversityLondonOntarioCanada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & DentistryWestern UniversityLondonOntarioCanada
| | - Surim Son
- Gait and Brain Lab, Parkwood InstituteLawson Health Research InstituteLondonOntarioCanada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & DentistryWestern UniversityLondonOntarioCanada
| | - David Buzaglo
- Center for the Study of Movement, Cognition and Mobility, Neurological InstituteTel Aviv Sourasky Medical CenterTel AvivIsrael
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological InstituteTel Aviv Sourasky Medical CenterTel AvivIsrael
- Department of Physical Therapy, Faculty of Medicine, Sagol School of NeuroscienceTel Aviv UniversityTel AvivIsrael
- Rush Alzheimer's Disease Center and Department of Orthopedic SurgeryRush University Medical CenterChicagoIllinoisUSA
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy)KU LeuvenLeuvenBelgium
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Portlock GE, Smith MD, van Poelgeest EP, Welsh TJ. Therapeutic dilemmas: cognitive enhancers and risk of falling in older adults-a clinical review. Eur Geriatr Med 2023; 14:721-732. [PMID: 37418063 PMCID: PMC10447592 DOI: 10.1007/s41999-023-00821-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/14/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE Cognitive enhancers are the primary pharmacological therapy prescribed to those with dementia, comprising of memantine and the acetylcholinesterase inhibitors (AChEIs). The long-term cognitive and behavioural benefits of these medications, as well as their potential contribution to falls is currently debated, with recent Delphi studies being unable to reach consensus on whether these medications should be deprescribed. In this narrative clinical review, as part of a series on deprescribing in people at risk of falls, we explore the potential falls-related side effects experienced in people taking cognitive enhancers, alongside situations where deprescribing may be appropriate. METHODS We undertook a literature search of PubMed and Google Scholar, using terms capturing falls and cognitive enhancers, as well as consulting the British National Formulary and published Summary of Medicinal Product Characteristics. These searches informed the subsequent clinical review. RESULTS Cognitive enhancers should be subject to regular review, including confirmation of appropriate treatment indication, and occurrence of side effects in the context of falls. AChEIs, in particular, are associated with a broad range of side effects that can contribute to increased falls risk. These include bradycardia, syncope and neuromuscular effects. Where these have been identified, deprescribing should be considered, as well as alternative treatment options. Deprescribing studies have shown mixed results, likely due to considerable methodological heterogeneity. Several suggested guidelines exist to aid deprescribing decisions, many of which are highlighted in this review. CONCLUSIONS The use of cognitive enhancers should be regularly reviewed and decisions to deprescribe made on a case-by-case basis, considering both the risks and benefits of stopping these medications.
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Affiliation(s)
| | - Matthew D Smith
- Bristol Medical School, University of Bristol, Bristol, UK
- The Research Institute for the Care of Older People (RICE), The RICE Centre Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | | | - Tomas James Welsh
- Bristol Medical School, University of Bristol, Bristol, UK.
- The Research Institute for the Care of Older People (RICE), The RICE Centre Royal United Hospital, Combe Park, Bath, BA1 3NG, UK.
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
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6
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Yarnall AJ, Morris R. A cholinergic contribution to postural control and freezing of gait in Parkinson's disease. Brain 2023; 146:3110-3111. [PMID: 37403729 PMCID: PMC10393389 DOI: 10.1093/brain/awad223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
This scientific commentary refers to ‘Cholinergic system correlates of postural control changes in Parkinson's disease freezers’ by Roytman et al. (https://doi.org/10.1093/brain/awad134).
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Affiliation(s)
- Alison J Yarnall
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UK
- Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Rosie Morris
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
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Di Luca DG, Reyes NGD, Fox SH. Newly Approved and Investigational Drugs for Motor Symptom Control in Parkinson's Disease. Drugs 2022; 82:1027-1053. [PMID: 35841520 PMCID: PMC9287529 DOI: 10.1007/s40265-022-01747-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2022] [Indexed: 12/11/2022]
Abstract
Motor symptoms are a core feature of Parkinson’s disease (PD) and cause a significant burden on patients’ quality of life. Oral levodopa is still the most effective treatment, however, the motor benefits are countered by inherent pharmacologic limitations of the drug. Additionally, with disease progression, chronic levodopa leads to the appearance of motor complications including motor fluctuations and dyskinesia. Furthermore, several motor abnormalities of posture, balance, and gait may become less responsive to levodopa. With these unmet needs and our evolving understanding of the neuroanatomic and pathophysiologic underpinnings of PD, several advances have been made in defining new therapies for motor symptoms. These include newer levodopa formulations and drug delivery systems, refinements in adjunctive medications, and non-dopaminergic treatment strategies. Although some are in early stages of development, these novel treatments potentially widen the available options for the management of motor symptoms allowing clinicians to provide an individually tailored care for PD patients. Here, we review the existing and emerging interventions for PD with focus on newly approved and investigational drugs for motor symptoms, motor fluctuations, dyskinesia, and balance and gait dysfunction.
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Affiliation(s)
- Daniel Garbin Di Luca
- Edmond J. Safra Program in Parkinson's Disease, Movement Disorders Clinic, Krembil Brain Institute, Toronto Western Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nikolai Gil D Reyes
- Edmond J. Safra Program in Parkinson's Disease, Movement Disorders Clinic, Krembil Brain Institute, Toronto Western Hospital, Toronto, ON, Canada
| | - Susan H Fox
- Edmond J. Safra Program in Parkinson's Disease, Movement Disorders Clinic, Krembil Brain Institute, Toronto Western Hospital, Toronto, ON, Canada.
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Królicka E, Kieć-Kononowicz K, Łażewska D. Chalcones as Potential Ligands for the Treatment of Parkinson's Disease. Pharmaceuticals (Basel) 2022; 15:ph15070847. [PMID: 35890146 PMCID: PMC9317344 DOI: 10.3390/ph15070847] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 12/16/2022] Open
Abstract
Along with the increase in life expectancy, a significant increase of people suffering from neurodegenerative diseases (ND) has been noticed. The second most common ND, after Alzheimer’s disease, is Parkinson’s disease (PD), which manifests itself with a number of motor and non-motor symptoms that hinder the patient’s life. Current therapies can only alleviate those symptoms and slow down the progression of the disease, but not effectively cure it. So now, in addition to understanding the mechanism and causes of PD, it is also important to find a powerful way of treatment. It has been proved that in the etiology and course of PD, the essential roles are played by dopamine (DA) (an important neurotransmitter), enzymes regulating its level (e.g., COMT, MAO), and oxidative stress leading to neuroinflammation. Chalcones, due to their “simple” structure and valuable biological properties are considered as promising candidates for treatment of ND, also including PD. Here, we provide a comprehensive review of chalcones and related structures as potential new therapeutics for cure and prevention of PD. For this purpose, three databases (Pubmed, Scopus and Web of Science) were searched to collect articles published during the last 5 years (January 2018–February 2022). Chalcones have been described as promising enzyme inhibitors (MAO B, COMT, AChE), α-synuclein imaging probes, showing anti-neuroinflammatory activity (inhibition of iNOS or activation of Nrf2 signaling), as well as antagonists of adenosine A1 and/or A2A receptors. This review focused on the structure–activity relationships of these compounds to determine how a particular substituent or its position in the chalcone ring(s) (ring A and/or B) affects biological activity.
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Greene BR, Premoli I, McManus K, McGrath D, Caulfield B. Predicting Fall Counts Using Wearable Sensors: A Novel Digital Biomarker for Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2021; 22:54. [PMID: 35009599 PMCID: PMC8747473 DOI: 10.3390/s22010054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
People with Parkinson's disease (PD) experience significant impairments to gait and balance; as a result, the rate of falls in people with Parkinson's disease is much greater than that of the general population. Falls can have a catastrophic impact on quality of life, often resulting in serious injury and even death. The number (or rate) of falls is often used as a primary outcome in clinical trials on PD. However, falls data can be unreliable, expensive and time-consuming to collect. We sought to validate and test a novel digital biomarker for PD that uses wearable sensor data obtained during the Timed Up and Go (TUG) test to predict the number of falls that will be experienced by a person with PD. Three datasets, containing a total of 1057 (671 female) participants, including 71 previously diagnosed with PD, were included in the analysis. Two statistical approaches were considered in predicting falls counts: the first based on a previously reported falls risk assessment algorithm, and the second based on elastic net and ensemble regression models. A predictive model for falls counts in PD showed a mean R2 value of 0.43, mean error of 0.42 and a mean correlation of 30% when the results were averaged across two independent sets of PD data. The results also suggest a strong association between falls counts and a previously reported inertial sensor-based falls risk estimate. In addition, significant associations were observed between falls counts and a number of individual gait and mobility parameters. Our preliminary research suggests that the falls counts predicted from the inertial sensor data obtained during a simple walking task have the potential to be developed as a novel digital biomarker for PD, and this deserves further validation in the targeted clinical population.
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Affiliation(s)
| | - Isabella Premoli
- Biomarker Department, Division of Experimental Medicine, H. Lundbeck A/S, 2500 Copenhagen, Denmark;
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King′s College London, London SE5 9RX, UK
| | - Killian McManus
- Kinesis Health Technologies Ltd., D04 V2N9 Dublin, Ireland;
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland;
| | - Denise McGrath
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland;
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland;
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland;
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